Analysis of diagnostic data for sexually transmissible infections in South Australian Aboriginal Community Controlled Health Services (2008–16)

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 566
Author(s):  
Salenna R. Elliott ◽  
Sarah Betts ◽  
Katie Hobbs ◽  
Handan Wand ◽  
Alice R. Rumbold ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Health Program ◽  
Aboriginal Communities ◽  
Aboriginal Community ◽  
Diagnostic Data ◽  
Australian Aboriginal ◽  
Sti Testing ◽  
Sexually Transmissible Infections ◽  
Sexual Health Program

Background Australian Aboriginal communities experience a high burden of sexually transmissible infections (STIs). Since 2009, a comprehensive sexual health program has been implemented at nine Aboriginal Community Controlled Health Services in South Australia. This study assessed trends in STI testing and positivity using deidentified diagnostic data from this period (2008–16). Methods: Testing data for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) from one urban, three regional and five remote Aboriginal health services were analysed using logistic regression. Results: From 2008 to 2016, testing increased for CT (twofold), NG (threefold) and TV (sixfold). On average, 30% of testing occurred during an annual 6-week screen. Fewer males were tested (range 27–38% annually). Mean annual STI testing coverage was 28% for 16- to 30-year-old clients attending regional or remote services (2013–16). Positivity at first testing episode for all three infections declined during the study period. From 2013 to 2016, when testing was stable and changes in positivity were more likely to indicate changes in prevalence, there were significant reductions in CT positivity (adjusted odds ratio (aOR) 0.4; 95% confidence interval (CI) 0.2–0.5) and TV positivity (aOR 0.6, 95% CI 0.4–0.9), although declines were statistically significant for females only. There was no significant decrease in NG positivity (aOR 0.9; 95% CI 0.5–1.5). Conclusions: Since the sexual health program began, STI testing increased and STI positivity declined, but significant reductions observed in CT and TV positivity were confined to females. These findings suggest evidence of benefit from sustained, comprehensive sexual health programs in Aboriginal communities with a high STI prevalence, but highlight the need to increase STI testing among men in these communities.

Integrated community-based sexual health services for young people in urban areas: are we meeting the needs of the local community?

2008 ◽  
Vol 19 (10) ◽  
pp. 713-714 ◽  
Author(s):  
K M Forbes ◽  
N Rahman ◽  
S Mccrae ◽  
I Reeves
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Urban Areas ◽  
Local Community ◽  
Local Population ◽  
Nucleic Acid Amplification ◽  
Community Based ◽  
Transmitted Infection ◽  
Sti Testing ◽  
Hiv Test

Community-based sexual health services (SHS) are intended to improve access for people who may have difficulty attending traditional genitourinary medicine clinics. The objective of this study was to review uptake of sexually transmitted infection (STI) testing in an outreach clinic for those under 25 in an area where Black and minority ethnic groups comprise the majority of the local population. A retrospective case-notes review was undertaken of those attending. Standards were that Fraser guidelines should be completed in all under 16-year-old and all clients should be offered STI testing, HIV testing and contraception (if applicable) in accordance with local standards. One hundred and seventeen clients attended. Ten percent self-reported ethnicity was Asian. Thirty-six (31%) clients tested for chlamydia. Thirty (26%) had an HIV test. Five (14% of those tested) had a positive nucleic acid amplification test for chlamydia. Five (13%) of those requesting long term contraception had STI testing. This service has successfully improved access to STI screening. However, there may have been missed opportunities to offer tests in those requesting contraception. Under-representation of those of non-white ethnicity suggests access to SHS may be a particular problem and further work is required to improve the sexual health of the local community.

Barriers and facilitators of sexually transmissible infection testing in remote Australian Aboriginal communities: results from the Sexually Transmitted Infections in Remote Communities, Improved and Enhanced Primary Health Care (STRIVE) Study

Sexual Health ◽  
2015 ◽  
Vol 12 (1) ◽  
pp. 4 ◽  
Author(s):  
Belinda Hengel ◽  
Rebecca Guy ◽  
Linda Garton ◽  
James Ward ◽  
Alice Rumbold ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Team Work ◽  
Remote Communities ◽  
Improvement Program ◽  
Aboriginal Communities ◽  
Small Communities ◽  
Australian Aboriginal ◽  
Sti Testing ◽  
Primary Health

Background Remote Australian Aboriginal communities experience high rates of bacterial sexually transmissible infections (STI). A key strategy to reduce STIs is to increase testing in primary health care centres. The current study aimed to explore barriers to offering and conducting STI testing in this setting. Methods: A qualitative study was undertaken as part of the STI in Remote communities, Improved and Enhanced Primary Health Care (STRIVE) project; a large cluster randomised controlled trial of a sexual health quality improvement program. We conducted 36 in-depth interviews in 22 participating health centres across four regions in northern and central Australia. Results: Participants identified barriers including Aboriginal cultural norms that require the separation of genders and traditional kinship systems that prevent some staff and patients from interacting, both of which were exacerbated by a lack of male staff. Other common barriers were concerns about client confidentiality (lack of private consulting space and living in small communities), staff capacity to offer testing impacted by the competing demands for staff time, and high staff turnover resulting in poor understanding of clinic systems. Many participants also expressed concerns about managing positive test results. To address some of these barriers, participants revealed informal strategies, such as team work, testing outside the clinic and using adult health checks. Conclusions: Results identify cultural, structural and health system issues as barriers to offering STI testing in remote communities, some of which were overcome through the creativity and enthusiasm of individuals rather than formal systems. Many of these barriers can be readily addressed through strengthening existing systems of cultural and clinical orientation and educating staff to view STI in a population health framework. However others, particularly issues in relation to culture, kinship ties and living in small communities, may require testing modalities that do not rely on direct contact with health staff or the clinic environment.

Addressing the Adherence-Adaptation Debate: Lessons from the Replication of an Evidence-Based Sexual Health Program in School Settings

2019 ◽  
Vol 20 (7) ◽  
pp. 1074-1088
Author(s):  
Jenita Parekh ◽  
Elizabeth Stuart ◽  
Robert Blum ◽  
Valerie Caldas ◽  
Brooke Whitfield ◽  
...  
Keyword(s):  
Sexual Health ◽  
Health Program ◽  
Evidence Based ◽  
School Settings ◽  
Sexual Health Program

What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 119 ◽  
Author(s):  
Chris Bourne ◽  
Debbie Allen ◽  
Katherine Brown ◽  
Stephen C. Davies ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
Large Contribution ◽  
Geographical Variations ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Geographical Regions ◽  
High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, <5% and 20%; and (v) remote: <5%, 43%, <5% and 29%. There was considerable variation in proportions of STIs between and within AHSs (<5–100%). Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

scholarly journals Feasibility, Acceptability, and Preliminary Efficacy of a Brief Online Sexual Health Program for Adolescents

2019 ◽  
Vol 57 (2) ◽  
pp. 145-154 ◽  
Author(s):  
Laura Widman ◽  
Kristyn Kamke ◽  
Reina Evans ◽  
J. L. Stewart ◽  
Sophia Choukas-Bradley ◽  
...  
Keyword(s):  
Sexual Health ◽  
Health Program ◽  
Sexual Health Program
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